创伤性脑损伤后低钠血症的危险因素分析.pdf

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1、中国神经精神疾病杂志2014~第40卷第6期33l·论著·创伤性脑损伤后低钠血症的危险因素分析史保中”江雷振曲智锋李静马亚莉孟晓峰周江朝徐东晓朱刚毅【摘要】目的探讨创伤性脑损伤(TBI)后低钠血症的发生特点及其危险因素。方法回顾性分析我院136例中、重度TBI患者的临床资料，主要包括年龄、性别、损伤类型、GCS评分、手术、是否有脑水肿和颅底骨折等，并对上述因素与低钠血症的发生进行卡方检验和多因素Logistic回归分析。结果136例中、重度TBI患者中有56例发生低钠血症，经多因素Logistic回归分析，TBI后低钠血症的发生与患者的年龄、性别、损伤类型、是否开颅手术无关，而与患者的GCS

2、评分、是否合并脑水肿或颅底骨折关系密切。结论TBI患者如GCS≤8分、合并有脑水肿或颅底骨折，则易于发生低钠血症，需提前采取预防措施。【关键词】低钠血症创伤性脑损伤计算机体层摄影术Glasgow昏迷评分【中图分类号】R739．45【文献标识码】AClinicalanalysisofhyponatremiafollowingtraumaticbraininjury．SHIBaozhong,JIANGLe~hen,QuZhi—feng,LIring,MAYali,MENGXiaofeng,ZHOUJiangchao,XUDongxiao,ZHUGangyi．DepartmentofNeurosu

3、rgery,AffiliatedHospital,HenanUniversityofScience&Technology,No．24JinghuaRoad,Luoyang471003．China．Tel：0379-69823252．【Abstract】ObjectiveToinvestigatetheincidenceandetiologicalfactorsofhyponatremiafollowingtraumaticbraininjury(TBt)andanalyzetherelationshipbetweenhyponatremiaandthepatient’Sage，gender，

4、typeofinjury，Glasgowcomascale(GCS)，operationandcomputerizedtomography(CT)scanofhead．MethodsClinicaldataof136pa·tientswithmoderateorsevereTBIinourhospitalwereanalyzedretrospectively，includingpatient’Sage，gender，typeofinjury，GCS，operation，brainedemaandbasalskullfracture．Therelationshipbetweenclinical

5、dataandhyponatremiawereanalyzedstatisticallybyChi—squaretestandmuhivariateLogisticregressionanalysis．ResultsTherewere56pa-tientswithhyponatremiain136patients(81males)withmoderateorsevereTBI．MultivariateLogisticregressionanalysisshowedthathyponatremiasecondarytoTB1wasnotassociatedwithpatient’Sage，ge

6、nder，typeofinjuryandoperationornot．However，therewasahighcorrelationbetweenhyponatremiafollowingTBIandclinicalcharacteristicsofTBIatear—lystage，suchasGCS，brainedemaandbasalskullfracture．ConclusionsPatientswithTBIismorelikelytodevelophy—ponatremiawhentheyhavethefollowingclinicalfactors，suchasGCS~<8，b

7、rainedemaorbasalskullfracture．Preven-tivemeasuresshouldbegiventothesepatientsinadvance．【Keywords】HyponatremiaTraumaticbraininjuryComputerizedtomographyGlasgowcomascale低钠血症在神经外科多见于创伤性脑损伤约33％以上并发低钠血症。若低钠血症不能得